New Scientist reports on a recent imaging study of young men expert in violent video games. The study scanned their brains while playing such a game. The report (I don't know whether the researchers themselves said this, or whether it was the journalist's interpretation) claimed that the findings suggest that their brains react as if they are treating the violence as real.
Other studies have already shown us a number of instances where our imagining of a situation produces similar brain activity to the actual situation; we still know the difference! Moreover, our response to violent situations is not by any means a simple one, and I think it would be foolish to assume there are not significant differences in the brain's response to an imaginary violent situation and a real one.
Interestingly, another imaging study that's been in the news lately has been a study of the female orgasm. I mention this study because it did show a difference in the brain activity of women who were really having an orgasm and women who were faking it. (If you're like me, you're still trying to get over the fact that they found people willing and able to go through this experience while being scanned! Apparently the biggest stumbling block was cold feet; a pair of socks fixed that.)
You could conclude from this that there is something special about orgasm that means pretence is not the same as the real thing, but in fact the point is it all depends on what you're looking for: similarities or differences. Imaging studies are always interesting -- I adore them myself -- but you should always bear in mind that they can't look at everything that's going on in the brain, they have to select what they're interested in.

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